经尿道双极等离子电切治疗肾移植后膀胱肿瘤的疗效及预后分析

发布时间：2018-03-26 17:41

  本文选题：经尿道双极等离子电切术　切入点：移行细胞癌　出处：《中国微创外科杂志》2016年04期

【摘要】：目的探讨经尿道双极等离子电切治疗肾移植后膀胱肿瘤的疗效和安全性,评价术后肿瘤复发的危险因素。方法 2009年9月~2014年6月采用经尿道双极等离子电切术治疗肾移植术后膀胱肿瘤16例,术中汽化切割肿瘤直达深肌层,术后定期膀胱灌注化疗。术后患者定期随访,观察肿瘤复发情况。采用Cox比例风险回归模型分析影响肿瘤复发的危险因素。结果 16例均成功完成经尿道双极等离子电切术,平均手术时间34.1 min(15~60 min)。术后随访时间14~62个月,中位随访时间45个月,肿瘤复发率50.0%(8/16),其中87.5%(7/8)术后2年内复发。多因素分析表明,原肾马兜铃酸肾病(HR=7.040,95%CI:1.411~35.121,P=0.017)与肿瘤直径≥3 cm(HR=8.230,95%CI:1.055~59.834,P=0.046)是术后复发的危险因素。结论经尿道双极等离子电切术是治疗肾移植术后非肌层浸润膀胱肿瘤的有效方法,切除效率高,安全性较好。术后仍有较高的复发率,大多数病例术后2年内复发,原肾马兜铃酸肾病、肿瘤直径≥3 cm的患者,术后复发风险较高。
[Abstract]:Objective to evaluate the efficacy and safety of transurethral bipolar plasma resection in the treatment of bladder tumor after renal transplantation. Methods from September 2009 to June 2014, 16 cases of bladder tumor after renal transplantation were treated by transurethral bipolar plasma resection. The patients were followed up regularly to observe the recurrence of tumor. Cox proportional risk regression model was used to analyze the risk factors of tumor recurrence. Results all the 16 patients underwent transurethral bipolar plasma resection successfully. The mean operative time was 34.1 min(15~60. The mean follow-up time was 14 ~ 62 months, and the median follow-up time was 45 months. The recurrence rate of tumor was 50.0% / 16%, 87.5% / 8% of which recurred within 2 years after operation. Proto-aristolochic acid nephropathy (HRN) 7.040C95CI1.411115121P0.017) and the diameter of tumor 鈮，

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